Workshop Proposal Form

Workshop Title (10 words or less):

Workshop Description and Expected Outcome: Please include your objectives and the expected outcomes of that workshop. What do you expect participants to learn? (Parts of this may be printed in the program. 75 words or less):

Subject area(s) covered:

Length of Presentation:

1 hour 2 hours (Mandatory break after first hour.)

Preferred Day:
(We cannot guarantee a particular day, but every effort will be made to honor your preference.)

Thursday Friday Either Day

Lead Presenter:

Title

First Name *

Last Name *

Address

Suite

City

State		Zip

Phone *

Email *

Program

Additional Presenter(s): (Please provide a complete list of all presenters.)

First Name

Last Name

Title

Program

First Name

Last Name

Title

Program

First Name

Last Name

Title

Program

Please submit proposals by November 27, 2009.

Please submit the AV Request Form and Presenter Request for CEUs when you submit the Workshop Proposal Form or we may not be able to fill your request.

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